@mkaften this is the biggest problem, but also the biggest reason for success with aquablation. Because there is no heat compared to other methods there is less risk to successful outcome, but it also means more bleeding because the procedure itself doesn't cauterize vessels. Here's my guess. So the doctor has to manually do it which is not a effective. The bigger the gland perhaps the more opportunity to miss something. Maybe luck plays a part. I believe this is why the practice that did my procedure does PAE just before the aquablation, studies have shown or to be a very effective way to reduce bleeding and quicken recovery. I'm not advocating for the procedure, i had my concerns, including the additional risk of the PAE procedure, but my recovery was only 24 hours with the catheter and I had very minimal bleeding after. However, the PAE wasn't a breeze either. The procedure was easy, but there is a lot of initial inflammation which was painful and because I had a large median lobe I nearly lost the ability to urinate before the aquablation which was 5 days after PAE. Certainly there are horror stories, but most regular aquablation seem to have minimal bleeding and a catheter for only 2 to 3 days. I looked at it this way, my enlarged prostate want going away, it was only going to get worse, so it's a risk I had to take. Delaying only increases the risk and worsens the outcome of the procedure. Just one guys opinion.